Heart Failure in Children Part I: History, Etiology, and Pathophysiology

Heart Failure in Children Part I: History, Etiology, and Pathophysiology
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DOI:
10.1161/circheartfailure.108.820217
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发表时间:
2009-01-01
影响因子:
9.7
通讯作者:
Pearson, Gail D.
Pearson, Gail D.
中科院分区:
医学1区
文献类型:
--
作者:
Hsu, Daphne T.;Pearson, Gail D.

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为什么儿童心力衰竭很重要?如果我们只考虑受影响的人数,成人心力衰竭显然是一个更引人注目的公共卫生问题。然而,相对较小的数字掩盖了儿科心力衰竭的整体经济和社会影响。当儿童因心力衰竭住院时,儿童的费用比成人高得多,因为经常需要手术或导管介入。医疗保健的需求会破坏家庭结构,对父母的经济生产力产生不利影响。当一个孩子死于心力衰竭时,经济影响会被极大地放大,因为每一个死亡都会损失潜在的生产年数。由于这些和其他原因,儿童心力衰竭是一个严重的公共卫生问题。此外,越来越多的心力衰竭儿童正在进入成年期,这是因为医疗和外科心力衰竭治疗的成功应用以及先天性心脏病手术结果的改善。更好地了解儿童心力衰竭的病理生理学可能有助于这些儿童成年后的治疗策略。此外,鉴于最近心脏发育和心脏遗传学对儿科心血管疾病影响的研究激增,儿科发现也将使心力衰竭成人受益的可能性并不排除。
Why is heart failure in children important? If we just consider the number of individuals affected, adult heart failure is clearly a more compelling public health problem. However, the relatively small numbers belie the overall economic and social impact of pediatric heart failure. When a child is admitted to the hospital for heart failure, the costs are considerably higher for children than adults because of the frequent need for surgical or catheter-based intervention. The demands of medical care can fray the family structure and adversely affect parental economic productivity. When a child dies of heart failure, the economic impact is magnified enormously because of the number of potentially productive years lost per death. For these and other reasons, heart failure in children is a serious public health concern. In addition, growing numbers of children with heart failure are reaching adulthood because of the successful application of medical and surgical heart failure therapies and the improved outcomes of congenital heart surgery. A greater understanding of the pathophysiology of heart failure in childhood may help inform therapeutic strategies once these children become adults. Furthermore, given the recent explosion of research in the impact of cardiac development and cardiogenetics on pediatric cardiovascular disease, it is not outside the realm of possibility for a pediatric discovery to be made that will also benefit adults with heart failure.